胃肠外科新生儿围术期凝血功能变化的影响因素分析

发布时间：2018-04-30 23:00

本文选题：凝血功能障碍 + 新生儿　；参考：《重庆医科大学》2017年硕士论文

【摘要】：目的:分析胃肠外科新生儿围术期凝血功能变化的影响因素。方法:回顾性调查分析2012年6月~2016年4月我院胃肠新生儿外科的323例新生儿凝血指标[血浆凝血酶原时间(PT)、部分活化凝血活酶时间(APTT)、凝血酶时间(TT)及血浆纤维蛋白原(Fib)]及围术期相关临床资料,根据术后4小时内凝血指标结果分为轻度异常组、明显异常组及正常组,分析三组术后4小时内凝血指标的差异,并分析围术期凝血功能障碍相关危险因素。结果:术后4小时内凝血指标异常新生儿158例,其中轻度异常61例,明显异常97例,单因素分析结果显示三组新生儿年龄、术前合并肺炎、腹膜炎、手术级别、手术时间、术中有创穿刺置管、输注红细胞悬液(RBC)及羟乙基淀粉、围术期低钙差异具有统计学意义(P0.05)。多元logistic回归分析结果显示:术前合并肺炎、围术期低钙、有创穿刺置管是新生儿术后4小时内凝血指标异常的独立危险因素(P0.05)。结论:在围术期管理时,应积极治疗肺炎、纠正低钙血症及选用浓度低于6.25u/ml的肝素溶液或生理盐水护理动静脉,以减少新生儿术后凝血功能障碍的发生。
[Abstract]:Objective: to analyze the factors influencing the changes of coagulation function during the perioperative period of neonatal surgery in gastrointestinal surgery. Methods: a retrospective study was conducted to analyze the blood coagulation parameters [plasma prothrombin time (PT), partial activated thromboplastin time (APTT), thrombin time (TT) and plasma fibrinogen (Fib) in 323 cases of neonatal surgery in our hospital in June 2012 ~2016 years. The related clinical data of perioperative period were divided into mild abnormal group, obvious abnormal group and normal group according to the results of coagulation index within 4 hours after operation. The difference of coagulation indexes within 4 hours after operation was analyzed in the three groups, and the risk factors related to coagulation dysfunction during the perioperative period were analyzed. Results: 158 cases of abnormal coagulation index in 4 hours after operation were mild. Abnormal 61 cases, obviously abnormal 97 cases, single factor analysis showed that the age of three groups of newborns, preoperative combined pneumonia, peritonitis, operation level, operation time, invasive puncture tube, infusion of red cell suspension (RBC) and hydroxyethyl starch, the difference of low calcium in perioperative period was statistically significant (P0.05). Multivariate logistic regression analysis showed: preoperative Combined pneumonia, perioperative hypocalcemia and invasive catheterization are independent risk factors for abnormal coagulation index within 4 hours after the operation of the newborn (P0.05). Conclusion: during the perioperative management, we should actively treat pneumonia, correct hypocalcemia and use heparin solution or saline solution of lower concentration than 6.25u/ml to nurse the blood and vein in order to reduce the postoperative coagulation work of the newborns. An obstacle can happen.

【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R726.1

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